AHRA: Joint Commission radiation recommendations—just add leadership

MINNEAPOLIS—The Joint Commission’s Sentinel Event Alert, Issue 47, from 2011, made a number of recommendations to reduce the radiation risks of diagnostic imaging. Two years later, practices that have not complied simply require leadership and initiative, as most of the suggested actions are well known and some are easily implemented, according to a presentation July 30 at the annual meeting of the AHRA.

Radiologists and radiology administrators need to step up to the plate on minimizing radiation risks, since anytime an article on the dangers of imaging is published in the media, regulatory bodies are either right in front or right behind the news, said Gene Bernieri, MBA, diagnostic imaging administrator at Orange Regional Medical Center in Middletown, N.Y.

“It’s on everybody’s radar,” he said.

Bernieri ran through the various categories of recommendations, straight from the Joint Commission report, including:

• Right test – Working with referring physicians to encourage the appropriate use of diagnostic imaging.
• Right dose – Adhere to the As Low As Reasonably Achievable guidelines and the recommendations of programs such as Image Gently and Image Wisely.
• Effective processes – Delineate risk reduction duties among staff and review oversight of protocols, including password protection.
• Safe technology – Conduct recommended quality control for equipment and have a qualified medical physicist test diagnostic imaging equipment.
• Safety culture – Make sure employees reflect an attitude that prioritizes the pursuit of safety. Actively participate in national dose registries.

Bernieri said many of these items, such as checking out information published on the Image Gently and Image Wisely websites, are well known, but are often neglected, and he implored the audience to take action. “We need, as leaders, to go in, get those initiatives, and make them work, and that’s what the Joint Commission wants.”

On the topic of exposure reduction software embedded in scanning equipment, Bernieri expressed frustration at vendors who charge a high price for this vital technology as opposed to including it as a standard feature. He relayed an anecdote about an equipment purchase in which his organization had to forgo unlocking the exposure reduction capabilities of a piece of equipment during the initial purchase, only to have the price raised considerably one year later when the organization eventually returned to implement it. With due respect to the importance of research and development costs, this practice is wrong, alleged Bernieri.

“We here as leaders have to make choices when we buy equipment, and if [vendors] are not putting it in for nothing, and somebody else is, maybe I would jump out of my [comfort zone] and send a message.”